O5-5 Neighbourhood Walkability and Physical Activity: Moderating Role of a Physical Activity Interventions in Overweight and Obese Older Adults with Metabolic Syndrome

Abstract Background While urban built environments might promote active ageing, an infrequently studied question is how the neighbourhood walkability modulates physical activity changes during a physical activity intervention program in older adults. We assessed the influence of objectively assessed neighbourhood walkability on the change in physical activity during the intervention program used in the ongoing PREvención con DIeta MEDiterránea (PREDIMED)-Plus trial. PREDIMED-Plus is a parallel-group, randomized trial which tested the effect of an intensive lifestyle intervention on cardiovascular disease prevention, in overweight and obese participants with the metabolic syndrome. Method The present study involved 228 PREDIMED-Plus senior participants aged between 55 to 75, recruited in Palma de Mallorca (Spain). Overweight/obese older adults with metabolic syndrome were randomized to an intensive weight-loss lifestyle intervention or a control group (106 intervention group and 122 control group). A home neighborhood environment walkability index (residential density, land use mix, intersections density) was calculated using geographic information systems (1km sausage-network buffer). Physical activity was assessed using accelerometer for seven days, and a REGICOR validated physical activity questionnaire, at baseline and 2 follow-up visits (six-months and one-year later). Generalized Additive Mixed Models (GAMMs) were fitted to estimate the association between the neighbourhood walkability index and changes in physical activity during follow-up. Results Higher neighbourhood walkability (1 z-score increment) was associated with moderate-to-vigorous accelerometer assessed physical activity duration, (ß = 3,44; 95% CI = 0.52;6.36 minutes per day). When analyses were stratified by intervention arm, the association was only observed in the intervention group (ß = 6.357; 95% CI = 2.07;10.64 minutes per day) (p for interaction = 0.055). There were no statistically significant associations between neighbourhood walkability and self-reported physical activity nor brisk walking duration. Conclusions The results indicate that the walkability of the neighbourhood could support a physical activity intervention, helping to maintain or increase older adults' objectively measured physical activity. This research may modify evidence on whether environmental factors modify habits acquisition during physical activity intervention programs.


Background
Technology-based physical activity interventions (TbPAI) have recently been shown to be effective for care of obese women (Cotie et al., 2018). Therefore, it is necessary to assess the acceptability of TbPAI to ensure dissemination and usage in the treatment of obesity (Venkatesh et al., 2012). As such, the purpose of this study was to: (1) identify acceptability profiles of three TbPAI in obesity care (e.g., active video games, mobile applications, videoconferencing); (2) examine the issues of consistency or change of acceptability profiles for the same individual across the three technology; and (3) explore whether technology acceptability profiles were associated with motivation for physical activity (PA), general causality orientations for PA and sociodemographic data. Methods Three hundred and twelve women with a mean age of 30.7 (SD=7.1) years, and a mean BMI of 34.9 (SD=9.2) kg/m 2 were recruited from health services that provide obesity management. Enrolled participants completed an online survey including the following measures: motivation for PA, general causality orientations for PA, TbPAI acceptability for the three selected technologies based on the UTAUT2 model (Venkatesh et al., 2012), and sociodemographic data. Ethical approval was gained by local committee, and informed consent were obtained from the participants before data collected. We used a Latent Profile Transition Analysis (LPTA) approach.

Results
A 2-class model (high and low acceptability) best described latent classes for each technology. Acceptability profiles changed over the technologies. Among our sample, only 8.0% (n = 25) of women have low acceptability of all technologies, and 57.7% (n = 180) have high acceptability of all technologies. The covariate effect estimates showed significant effects of: (a) age and control causality orientation on video games acceptability profiles, (b) intrinsic motivation and impersonal causality orientation on videoconferencing profiles, and (c) control and impersonal causality orientations on mobile applications profiles. Conclusions A LPTA approach may prove usefulness in understanding TbPAI acceptability in the obesity treatment and have Abstract citation ID: ckac094.037 O5-5 Neighbourhood Walkability and Physical Activity: Moderating Role of a Physical Activity Interventions in Overweight and Obese Older Adults with Metabolic Syndrome Antoni Colom 1,2 , Suzanne Mavoa 3,4 , Maurici Ruiz 5 , Julia Wä rnberg 6,2 , Josep Muncunill 7 , Jadwiga Konieczna 1,2 , Francisco Javier Baró n-Ló pez 8,2 , Guillem Vich 9 , Montserrat Fitó 10,2 , Jordi Salas-Salvadó 11,2 , Dora Romaguera

Background
While urban built environments might promote active ageing, an infrequently studied question is how the neighbourhood walkability modulates physical activity changes during a physical activity intervention program in older adults. We assessed the influence of objectively assessed neighbourhood walkability on the change in physical activity during the intervention program used in the ongoing PREvenció n con DIeta MEDiterránea (PREDIMED)-Plus trial. PREDIMED-Plus is a parallel-group, randomized trial which tested the effect of an intensive lifestyle intervention on cardiovascular disease prevention, in overweight and obese participants with the metabolic syndrome.

Method
The present study involved 228 PREDIMED-Plus senior participants aged between 55 to 75, recruited in Palma de Mallorca (Spain). Overweight/obese older adults with metabolic syndrome were randomized to an intensive weight-loss lifestyle intervention or a control group (106 intervention group and 122 control group). A home neighborhood environment walkability index (residential density, land use mix, intersections density) was calculated using geographic information systems (1km sausage-network buffer). Physical activity was assessed using accelerometer for seven days, and a REGICOR validated physical activity questionnaire, at baseline and 2 follow-up visits (six-months and one-year later). Generalized Additive Mixed Models (GAMMs) were fitted to estimate the association between the neighbourhood walkability index and changes in physical activity during follow-up.

Results
Higher neighbourhood walkability (1 z-score increment) was associated with moderate-to-vigorous accelerometer assessed physical activity duration, (ß = 3,44; 95% CI = 0.52;6.36 minutes per day). When analyses were stratified by intervention arm, the association was only observed in the intervention group (ß = 6.357; 95% CI = 2.07;10.64 minutes per day) (p for interaction = 0.055). There were no statistically significant associations between neighbourhood walkability and self-reported physical activity nor brisk walking duration.

Conclusions
The results indicate that the walkability of the neighbourhood could support a physical activity intervention, helping to maintain or increase older adults' objectively measured physical activity. This research may modify evidence on whether environmental factors modify habits acquisition

Background
In contrast to leisure time physical activity (LTPA), occupational physical activity (OPA) does not have similar beneficial health effects. These differential health effects, also known as the physical activity health paradox, might be explained by dissimilar effects of LTPA and OPA on cardiorespiratory fitness (CRF). This study aims to investigate the association between deviceworn measures of physical behaviors during both work and leisure time and CRF among workers with high level of OPA.

Methods
Our results are based on a sample of 309 workers employed within the service and production sector from the crosssectional FEPA (Flemish Employees' Physical Activity) study. OPA and LTPA were measured using two Axivity AX3 accelerometers, worn on the back and right thigh for 2 to 4 consecutive working days. CRF levels were obtained by the Harvard step test. Compositional multiple linear regression analyses were used to analyze the relations, adjusted for age, sex, education, smoking, BMI, moderate-to vigorous physical activity (MVPA), and physical work demands.

Results
During work time, more sedentary behavior (SB) was associated with higher CRF when compared relatively to time spent on other work behaviors, while more SB during leisure time was associated with lower CRF when compared to other leisure time behaviors. Reallocating more time to MVPA from the other behaviors within leisure time was positively associated with CRF, which was not the case for MVPA during work.

Conclusion
Our results emphasize the need for taking the domain-specific nature of physical activity into account to understand its relation to CRF. Guidelines usually do not differentiate between OPA and LTPA in their recommendation to participate in at least 150 min of physical activity per week, regardless of the OPA level. Workers already meeting this recommendations through OPA might therefore mistakenly think that they already meet the recommendations on physical activity and think they can spend their leisure time in a